Welcome

Welcome to the POZ/AIDSmeds Community Forums, a round-the-clock discussion area for people with HIV/AIDS, their friends/family/caregivers, and
others concerned about HIV/AIDS. Click on the links below to browse our various forums; scroll down for a glance at the most recent posts; or join in the
conversation yourself by registering on the left side of this page.

Privacy Warning: Please realize that these forums are open to all, and are fully searchable via Google and other search engines. If you are HIV positive
and disclose this in our forums, then it is almost the same thing as telling the whole world (or at least the World Wide Web). If this concerns you, then do not use a
username or avatar that are self-identifying in any way. We do not allow the deletion of anything you post in these forums, so think before you post.

The information shared in these forums, by moderators and members, is designed to complement, not replace, the relationship between an individual and his/her own
physician.

All members of these forums are, by default, not considered to be licensed medical providers. If otherwise, users must clearly define themselves as such.

Forums members must behave at all times with respect and honesty. Posting guidelines, including time-out and banning policies, have been established by the moderators
of these forums. Click here for “Am I Infected?” posting guidelines. Click here for posting guidelines pertaining to all other POZ/AIDSmeds community forums.

We ask all forums members to provide references for health/medical/scientific information they provide, when it is not a personal experience being discussed. Please
provide hyperlinks with full URLs or full citations of published works not available via the Internet. Additionally, all forums members must post information which are
true and correct to their knowledge.

Author
Topic: United Healthcare Insurance (Read 3311 times)

Does anyone have experience with United Healthcare Insurance Company? I understand they consider once a day HIV regimens a specialty medicine. Would like to know what kind of copays they have. Apparently they use OptumRX for specialty medications.

I've only had blue cross in the past and that was before I started hiv treatment. I'm receiving medicine through ADAP right now and am a little nervous about not being able to afford my medicine .

I am on a United Healthcare plan through my employer. I take Striblid and, yes I have to order through OptumRx. This is a recent change. Prior to July 1, I could use the Walgreen's Specialty located in the same building as my physician. OptumRx is hit or miss service wise. At times it is almost like dealing with an off shore call center.

My copay is $60 per 30 day supply. OptumRx does not provide 90 day refills. In their favor, they do accept my Gilead co-pay card which covers the entire co-pay making my out of pocket cost $0.

Please note that this is all dependent on which UHC plan in which you are enrolled. Your mileage my vary.

Thanks for your reply. I read that my copay through optumrx will be a maximum of $100 per 30 day supply. I think atripla will assist up to $1200 per year so it should work out OK. Now to worry about my doctor visits and lab work copays.

Like piscina said you should apply for the Gilead Co-Pay assist card. You will pay nothing out of pocket they cover I believe upto 240 a month. Just have to register for it pretty simple. Atripla, Complera and Stribild all use the Gilead card.

I too have United Healthcare through employer and I get to go to the pharmacy of my choosing. I guess it depends what the employer chooses. My copay is $40 but the copay assist card wipes that out.

As for income, I don't think so. I called the Gilead copay assistance number today and they went ahead and signed me up. Gave me a plan number, bin number, and member number. They told me as long as I want getting medication through government assistance (ie, Medicaid) that the card would cover up to $400 copay each month.

"...health will finally be seen not as a blessing to be wished for, but as a human right to be fought for." Kofi Annan

Nymphomaniac: a woman as obsessed with sex as an average man. Mignon McLaughlin

HIV is certainly character-building. It's made me see all of the shallow things we cling to, like ego and vanity. Of course, I'd rather have a few more T-cells and a little less character. Randy Shilts

I just went to Gilead's website and signed up for their co-pay assistance. To do that go to www.gileadcopay.com and click enroll. No questions are asked about income and you can get the card immediately by printing it out or saving it to your phone. It took me about 2 minutes total. Be warned That it does require that you give an address as a paper card will also be mailed to you.

Finally got my first script filled. $100 copay for 30 Day supply. Gilead copay assistance covered the whole amount. The only issue I had was that copay assistance only works for 30 Day supply at a time. The specialty pharmacy set me up to email and remind me when it's time to refill.

HiYou can get 90 day supply of Atripla from optum RX or from a private pharmacy that are approved for 90 day supply as long as your doctor write a 90 day supply on your prescription.I have united healthcare and got a 90 day from optum RX last year, this year I have the same insurance but moved to a private pharmacy because optum RX are difficult to deal with.

I think the issue was the copay card not covering a 90 day supply. The insurance company said that they would cover up to 400 per month but not a 90 day supply. Works out OK because they call to remind me every month and I pay $0 out of pocket.